Finding new treatments for socio-emotional disorders after traumatic brain injury

What is this research about?

Severe traumatic brain injuries are common in Australia with 22,000 new cases each year. Many people with severe injuries regain physical and cognitive abilities and, to all intents and purposes, appear to have made a good recovery. But often they experience problems in the sphere of personality, social functioning and communication which are ongoing and disrupt their friendships, family and work lives. 

They may experience problems regulating their emotions. This may mean they are under-aroused and apathetic with no motivation to start anything or to persist with an ongoing task. Alternatively, they may be easily irritated and prone to anger, saying and doing things that upset other people.  Another common problem is that people with such brain injuries have trouble understanding the social cues that other people give out. They may fail to recognise the emotional state of other people and also have difficulty seeing things from someone else’s point of view. There are currently very few treatments for these kinds of disorders and in this project we are trialling a number of new approaches. These include electrical stimulation of the brain, biofeedback to normalise heart rate and cognitive-behavioural approaches aimed at learning new skills in social thinking.

Professor Skye McDonald leads the research at the UNSW School of Psychology into finding new treatments for socio-emotional disorders after traumatic brain injuries.

Other academics or researchers working on the project:

Direct cortical stimulation: In this task electrodes are placed on the head and a very weak electrical current is passed through the brain. We are aiming to determine if direct cortical stimulation of this kind can improve working memory and attention.  If attention is improved this may help with emotion regulation. Research fellow, Dr Jacqueline Rushby is leading this project along with research assistant Frances DeBlasio and post doctoral fellows Travis Wearne and Katie Osborne-Crowley.

Heart Rate Variability: Biofeedback: Good heart rate variability (changes in the time between heart beats) is known to be accompanied by good emotional regulation and well being. In this project we are training people with brain injuries to regulate their breathing which, in turn, improves heart rate variability. They come in for several sessions of biofeedback training where they learn to adjust their breathing rate by following a symbol on a computer screen. This project is being coordinated by Dr Travis Wearne with research assistants Samantha Allen and Emily Trimmer.

Social cognition training:  We have shown in earlier work that people with brain injury can re-learn skills in recognising emotions in other people. We developed a 12 week program where these skills were taught and practiced leading to better emotion recognition afterwards.  This project will take a similar approach but focuses on a broader range of social cognitive skills.  Anneli Cassels is a trained clinical psychologist who is a current PhD candidate. She will be developing the social cognition training program which will focus on improving the ability to take the perspective of other people and to consider social information from multiple perspectives.  

Recent grants awarded:

NH&MRC Project Grant 1081923 (2015-2018) Emotion regulation after brain injury: New approaches to remediation (McDonald, Tate, Rushby & Francis)

Publications related to this research:

Francis, H. M., Fisher, A., Rushby, J. A., & McDonald, S. (2016). Reduced heart rate variability in chronic severe traumatic brain injury: Association with impaired emotional and social functioning, and potential for treatment using biofeedback. Neuropsychological Rehabilitation, 26(1), 103-125. doi:10.1080/09602011.2014.1003246

Francis, H., Penglis, K. and McDonald, S.(2015) Manipulation of heart rate variability can modify responses to anger inducing stimuli. Social Neuroscience, 22, 1-8

Cassels, A., McDonald, S., Kelly, M., & Togher, L. (In Press) Learning from the minds of others: A review of social cognition treatments and their relevance to traumatic brain injury Neuropsychological Rehabilitation (accepted 31 Oct 2016)

Rushby, J., McDonald, S., Fisher, A.C., Kornfeld, E.J., De Blasio, F.M., Parks, N., Piguet, O. (2016), Brain volume loss contributes to arousal and empathy dysregulation following severe traumatic brain injury. Neuroimage: Clinical 12, 607-614, http://dx.doi.org/10.1016/j.nicl.2016.09.017

Fisher, A. C., Rushby, J. A., McDonald, S., Parks, N., & Piguet, O. (2015). Neurophysiological correlates of dysregulated emotional arousal in severe traumatic brain injury. Clinical Neurophysiology, 126(2), 314-324. doi:10.1016/j.clinph.2014.05.033

Rushby, J.A., McDonald, S., Randall, R., de Sousa, A., Trimmer, E. & Fisher, A. (2013) Impaired emotional contagion following severe traumatic brain injury. International Journal of Psychophysiology, 89(3), 466-474 DOI: 10.1016/j.ijpsycho.2013.06.013

Rushby, J. A., Fisher, A. C., McDonald, S., Murphy, A., & Finnigan, S. (2013). Autonomic and neural correlates of dysregulated arousal in severe traumatic brain injury. International Journal of Psychophysiology, 89(3), 460-465 DOI: 10.1016/j.ijpsycho.2013.05.009

Labs:

Skye McDonald's Lab

Moving Ahead - Centre of Research Excellence in Brain Recovery